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I wouldn't jump to thinking about surgery yet. Yes it is an option. My Riley had it and it was a great success for her. But it isn't for all dogs. We were lucky and had a great neuro. I would just first concentrate on trying to get her comfortable. Most dogs do fine on medication although it is a progressive disorder. I would also say to not beat yourself up about not getting her diagnosed or treated sooner. It took me years to figure out what was going on with Riley. You are going to the ends of the earth to take care of Shiloh. That what matters now. Please let us know what happens tomorrow. I've been there and it is heartbreaking.

I appreciate that so much. I'm dealing with a lot of guilt. But that's probably normal. I just want to be able to enjoy her and hopefully tomorrow she'll feel better if we can get the nerve meds. We gave her the OTC med a little earlier and she seems to be resting peacefully.

Is there anything else we can do to make her more comfortable? Or is there anything specific we should avoid? We went to my parents house tonight for dinner and she was running and playing for a few minutes with our other dog. That was really great to see. But then as the night went on she seemed to feel much worse. Just wondering if all the running in the yard made her worse? I'm going to do as much learning about this as I can and read all the info you have suggested on the websites. I am so grateful to all of you! You have no idea how comforting it is to have your support. Shiloh and I appreciate it very much!

Sorry to say that I've only just caught up with your thread Lucky Star (a first name would be really nice - mine is Flo and I live in Birmingham, UK, sharing my life with 4 Cavaliers).

My 10 years old boy Rebel has SM and showed some but not all of the symptoms you describe. It took some time for my vet to find the right treatment to relieve his pain, but for the last 3 months or so he has been behaving like a dog of half his age and, can you believe it, finding fault with everything I do, or even some things that he even thinks might be considering doing.

I have some sensible advice here. The first thing is that you have no reason to blame yourself for the pain that Shiloh is going through. My Rebel came from a very highly respected and health conscious breeder that I knew well. After a few month she told me it might be possible that he was carrying inherited problems and advised me that he should not be used at stud. I am so glad I took that advice, because I had him MRI scanned at 6 yrs old and was astounded to be told he has a very large syrinx. His symptoms only became accute a couple of years later and it helped my vet to have pictures of the syrinx to work with and of course Dr Rusbridge's treatment matrix. If I hadn't taken Rebel along to the scanning session because I was already taking my breeding bitch, I think the outcome might have been very different, as my vet was one of those who had never seen SM before. Now she has 3 other SM patients from other toy breeds.

The second suggestion I want to make is for you to CHANGE YOUR VET. Sorry, but this person seems to be totally uncaring, unsimpathetic and only interested in making as much money out of you as he possibly can. This is not how a vet should be and I am sure there are other vets within travel distance of your home with a much better attitude. Vets are supposed to be compassionate and caring as well as being skilled and efficient diagnosticians and this man is neither. Time to move on, for Shiloh's sake if not yours.

A better vet will be only too glad to refer you on to a diagnostic consultation with a good neurologist and should be more than happy to work with the specialist to effectively ease Shiloh's pain.

So sorry to be so abrupt over this. As I read through your thread I was initially blinded by tears which were soon replaced by anger at the so called treatment given by this vet.

There is light at the end of the tunnel in most cases I have heard about. My Rebel is living proof of this, so please don't give up yet and please come back to us here for all the sympathetic support you need. There is usually somebody around, day or night.

Im just reading your post now and my heart breaks for you and Shiloh. Good luck in getting your little one sorted and when you have change your vet........he needs a serious education in controlling pain and what are the causes!!! Mel XXX

We went to the vet today, but saw a different doctor! She was wonderful. She has seen Shiloh a couple times over the last year when the other vet wasn't available, and she knows her history. She took as much time today with Shiloh as I could have hoped for. She watched all of the videos I had and did a basic neurological exam along with a physical. She listened, answered questions, and explained SM to me. She started Shiloh on 100 mg of gabapentin and said we can give it to her up to 3 x a day if needed, as long as the side effects are not too bothersome. We are holding off on the tramadol for now so we can see how she responds to the gabapentin. We are going back in 2 weeks to follow up and will talk about where to go from there. She also gave some probiotics to start to help with digestion so that if Shiloh still needs the tramadol she will have something to help her tummy. For now, I'm really hoping there is some improvement with the gabapentin. She has only had one dose so far, but at 1:30 am I will give her the 2nd. She didn't get the first dose until 5:30 pm today, since we couldn't get to the vet until 4pm.

Im so relieved that she finally has medication, and relieved she now has a vet that I feel comfortable with. Even though her original vet works out of the same office, we will never be visiting him again. Dr. Pearce was absolutely great, and apparently she is the vet that handles the neurological issues at this office.

As relieved as I am, I am also scared of what the future holds for Shiloh. Dr. Pearce was hopeful, but also honest about the reality. She said that bc Shiloh is so young and her quality of life has been so bad, she can't promise that she will get better. Obviously without an MRi to confirm the diagnosis we can't be 100% certain, but based on the symptoms she feels pretty strongly SM is what's going on. She said it would be pretty hard for us to put Shiloh down without knowing for sure, but that even if we had all the money in the world and had an MRI confirm it, brain surgery is the only other option besides meds. Dr. Pearce said a confirmed dx may help us feel some closure if we have to put her down, but that ultimately if she doesn't improve, we have to think about Shiloh's quality of life. This is all very overwhelming to me. She's still a baby. She's not even 2 yet. But looking back at all these videos, I just cry because I can see how miserable she is. Dr. Pearce said that after the meds, there's nothing else they can do. I'm still trying to let all of this sink in. I'm just....heartbroken. There are no words really. This disease is horrible. I've always felt that no matter what I do for Shiloh, it's never good enough. It never gets better. And if it comes to the end, and she tells me it's time, that will be the only thing I've ever done to stop her pain. I'll have to make that decision for her, and it will be the most hideous moment of my life.

I'm so sorry that Shiloh and you are going through all this. It's terrible to watch a beloved pet suffer. I'm glad you found a doctor who listened and is caring, and I'm sending good thoughts that the medication will help your little one.

I'm so glad you have found a sympathetic vet who is working actively to control Shiloh's pain. Try not to get too depressed at this stage, thinking about the future. There are still quite a lot of medications for you to try - 100mg of gabapentin is the lowest starting point. The most usual side effect with gabapentin is sleepiness for a week or two, but then it can make a real difference in controlling pain. It can also be in itself confirmation of SM, since it only acts on neurological pain, not on ordinary muscular pain for example.

Take a breath and another and another. You've just started down the long path of managing Shiloh's symptoms medically. Medication can take a while to work and get the right cocktail for your dog. What works for one dog does not necessarily work for another. Riley is on prednisone. For her, that's the only med that had any effect on her symptoms. For others, they have had to switch to Lyrica from gabapentin. So in my opinion, you've got a way to go before you need to start thinking about saying goodbye to your little girl. That being said, I know that it was devastating for each and every one of us who has an SM dog to get the diagnosis. You feel like your dog has been given a death sentence and I know I started to treat Riley with kid gloves. I looked at every day as if it were her last and I think I stopped seeing her for the sweet dog that she was. Instead, she became the SM. Now here it is 5+ years later and my wonder dog is still alive and is doing so well. Please don't let SM conquer you yet. You're doing an amazing job being such an advocate for Shiloh. Give the meds time to work and if those don't work, try upping the dosage or try different meds. And remember, we are always here for support and a friendly ear.

I can't add much more advice other than echo what has already been given to you. Both you and Shiloh have been through the mill with this and thank goodness you are now on the right track with her. Thankfully it looks like starting proper pain relief has already made a difference to how she is feeling and she can start to enjoy her life again.
Let the future take care of itself and concentrate on how Shiloh is now

Bosco was diagnosed before 18 months, he is now aged 5. He has had various drugs including gabapentin and is now on Lyrica. Life isn't a bed of roses for him, but he is doing ok, some days are good, others aren't so good.

With regard to her anal glands - she was probably in pain due to the SM, but either way, you can help her very simply by adding fibre such as a spoonful of bran to her meals.

Best of luck with her treatment, and keep us posted. There are lots of us on this board with dogs that have various degrees of SM/CM and there are lots of treatment options as you will have seen from the alogrithim, so if one thing doesn't work, there are other drugs or combinations of drugs that you can try.